AI UPDATE: USAID/FAO VISITORS REVIEW BURMA EFFORTS

UNCLAS SECTION 01 OF 04 RANGOON 000203

SIPDIS

STATE FOR EAP/MLS; USDA FOR FAS/PECAD, FAS/CNMP, FAS/AAD;
BANGKOK FOR USAID/RDMA: JMACARTHUR, APHIS: NCARDENAS, REO:
JWALLER; PACOM FOR FPA

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: EAGR EAID AMED PGOV CASC TBIO KLFU BM
SUBJECT: AI UPDATE: USAID/FAO VISITORS REVIEW BURMA EFFORTS

REF: A) 06 RANGOON 1776, B) RANGOON 1679

RANGOON 00000203 001.2 OF 004



1. (U) Summary: Burma has not reported any new cases of AI
since it contained a March-April 2006 outbreak in poultry
in Mandalay and Sagaing Divisions through extensive
culling. Recent sero surveillance detected AI antibodies
in ducks in Mandalay and Bago Divisions, but examination by
GOB, USAID and FAO specialists showed levels below those
set by OIE, and further tests proved negative. FAO's
Regional Avian Influenza advisor carried samples from
Mandalay to Thailand for testing, but said she was
confident that the poultry does not have H5N1. Visitors
from FAO and USAID RDMA in Bangkok reported improved
monitoring and continued cooperation and transparency from
GOB health/veterinary contacts, but expressed concern about
poor lab infrastructure, inadequate skills training, lack
of AI awareness in rural areas, and the continued
commingling of poultry with humans and other livestock in
many parts of the country. End summary.

Good News: Duck Follow-Up Tests Negative
--------------

2. (SBU) GOB officials provided useful updates on AI
efforts in Burma during the February 12 - 17 visits of
USAID Infectious Diseases Team Leader, Dr. John MacArthur,
USAID Animal Health Advisor Dr. Sudarat Damrongwatanapokin,
and FAO Regional AI Advisor Dr. Wantanee Kalpradith. The
GOB requested FAO assistance to evaluate samples collected
from ducks that tested positive for H5N1 during regular
sero surveillance in Mandalay and Bago Divisions. Dr.
Sudarat worked closely with Livestock Breeding and
Veterinary (LBVD) officials in their lab and made a field
trip to Bago to investigate further.


3. (SBU) On February 14, Dr. Sudarat told Charge that the
levels of AI antibodies in the samples were below the OIE
cutoff for a positive results, which signaled that the
ducks could have been exposed to the disease during the
2006 outbreak or that the test was detecting a non-H5 sub-
type of avian influenza. In other samples that met the OIE
criteria for a positive test, LBVD laboratory analysis did
not detect any virus. Dr. Sudarat expressed confidence
that the ducks do not have AI, based on the lack of
clinical signs associated with both the ducks and
neighboring chickens. On February 15, FAO carried
additional samples from ducks in Mandalay to the Department
of Animal Health in Bangkok for further evaluation.

Facing Inadequacies
--------------

4. (SBU) Dr. Sudarat praised the level of GOB openness and
transparency that she and the FAO team found during their
latest visit. She also noted that officials observed good
protocol in handling the specimens and showed the benefit
of previous training. She added, however, that, in many
areas, official capabilities are still inadequate,
including poor quality of labs, unreliable power supply,
inconsistent results, and inadequate skills training.


5. (U) In a February 14 meeting led by LBVD Director
General, Dr. Maung Maung Nyunt, Dr. Suadarat made the
following recommendations to address some of Burma's
inadequacies: create an inventory list of lab supplies;
collect at least 60 samples from each flock; provide more
regular electric power to labs; follow international
standards for testing; increase reliance on sero
surveillance; provide more training for staff; monitor egg
age for virus isolation; increase surveillance in wetlands;
concentrate more surveillance in high risk areas; and
expand H5N1 testing to quail, if possible. The DG added
other areas of concern, including the negative effect of
quail egg exports to India, which he claimed reached up to

RANGOON 00000203 002.2 OF 004


1 million eggs a day; problems reaching many remote areas,
including a jade mining town of 300,000 which he called a
"hidden city;" lack of funding for a livestock compensation
program; and the relatively small number of international
donors.


6. (U) According to the DG, GOB current priorities are:
strict biosecurity on farms, reducing range of birds,
reduced contact with live bird markets, disease monitoring
and reporting, and open information exchange.

But Progress in Assistance to Farmers
--------------

7. (U) In a formal presentation and lively discussion with
Drs. MacArthur, Sudarat and emboffs, the DG claimed the GOB
had made a great deal of progress in its response to AI.
He noted the ongoing sero surveillance conducted at village
homes, farms, markets, hatcheries, and wild bird
sanctuaries. He described new programs to reduce the
impact on farmers affected by extensive culling during the
outbreak. These include the allocation of 93 acres in
Sagaing Division for "Livestock Zones," outside of village
limits, where farmers with at least 500 chickens received
free leases, telephone connections, tube wells, subsidized
electricity, and day old chicks to restock their flocks.
LBVD has already distributed to farmers almost 100,000
chicks out of a target total of almost 264,000. Farmers
unaffected by the earlier culling also can build farms in
the Livestock Zones, but must pay for the lease and
services provided.


8. (U) In addition, according to the DG, the Livestock and
Fisheries Development Bank has begun to offer loans to
farmers at the concessional annual rate of 17% (less than
half the current market rate in Burma),renewable yearly.
He noted that these loans, in contrast to regular loans, do
not need to be secured by immovable property. The DG said
the GOB also provided some farmers with cell phone permits
which they could then resell at a profit. The DG
emphasized that these efforts were not a compensation plan
for the farmers, but "in-kind help" and "restocking" to
mitigate damage. The GOB cannot afford to replicate this
plan in the future, he said, because few international
donors had offered support.


9. (U) Dr. MacArthur suggested expanding LBVD's Livestock
Zones to include farms of 200 chickens or more, noting that
the outbreak primarily affected farms with 200-500
chickens. He also encouraged LBVD to learn whether farmers
thought the current government support provided enough
incentive for them to report any future outbreak. He also
mentioned that two LBVD laboratory technicians could
receive one month of funded AI training at Thailand's
National Institute of Animal Health and encouraged LBVD to
pursue this.


10. (U) The government has upgraded lab facilities, the DG
reported, and now has three labs, in Rangoon, Mandalay and
Taunggyi, that can perform serology testing for AI.
According to the DG, the GOB will also build a central
testing lab near Mandalay in 2008. Dr. Sudarat offered to
provide guidance on lab construction, based on Thai
experience.

How Widespread Is AI Awareness?
--------------

11. (U) According to the DG, awareness of the potential
threat of AI is now widespread among the people, including
farmers. He credited publicity sponsored by the GOB, JICA,
FAO, AusAID, UNICEF, and WHO. Every Township has organized
a team with members of the local poultry association,
General Administration officials and other local

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authorities, police, municipal authorities, government
veterinarians and health officials. He also noted that
USDA (the regime's political mass member organization)
members, Special Branch officers, and police investigators
work with local authorities to ensure regular reporting.
The DG cited recent official reporting and swift response
to the death of five sparrows in Chin State as an example
of countrywide awareness.


12. (SBU) WHO officials confirmed that township
coordinating teams are in operation, but noted that on
their trips around the country, they have observed few
public notices or signs warning about AI, even in high risk
areas close to Rangoon, such as Moyingyi wetlands in Bago
Division. The WHO Country Representative, Prof. Adik
Wibowo, expressed concern about the low level of awareness
around the country. She told us that her AI Team has
worked primarily with central government and
state/division-level officials, and will soon begin to
focus on more communication and coordination with township,
district, and village authorities as well.

Hospital Upgrades, Training and Communications
-------------- -

13. (SBU) At WHO, Professor Wibowo informed Dr. MacArthur
that the Japanese Trust Fund plans to provide $98,000 to
finance infrastructure renovations, to include isolation
wards and new ventilation systems, at each of the two
hospitals designated as primary AI care facilities, Waibagi
and Kandunadi. Wibowo said the Ministry of Health agreed
to upgrade facilities at seven state/division hospitals.
WHO hopes to use World Bank Trust Fund money for these
projects, she said. WHO also plans to conduct training and
capacity building for AI detection and reporting at all 17
state/division hospitals and recently concluded training of
Rapid Response Teams at the state/division level. WHO will
now move to township-level training for early AI warning
systems.


14. (SBU) Wibowo said she has open, regular communication
on AI with Ministry of Health authorities. She told us
that Ministry of Health officials immediately informed her
about the positive results from sero sampling of ducks,
although she had not previously heard about the sparrows in
Chin State. On February 21, Ministry of Health contacts
also told her about 15 crows found dead in Rangoon
Division, which tested positive for an H-type virus, but
negative for H5N1. The Ministry of Health and LBVD
conducted an investigation, including at the local wet
market, and sent samples to Bangkok for further
examination.

Foreign Assistance Put to Use
--------------

15. (U) At FAO, Country Representative Tang Zhengping told
Dr. MacArthur that FAO's USAID-funded activities will begin
in March 2007, and will end by October. FAO has hired six
national consultants and placed an FAO veterinarian at LBVD
(reftels). He said that the World Bank had agreed to
provide $1.3 million to FAO.


16. (U) At UNICEF, Communication Officer Susan Aitkin
informed us that the Japanese Trust Fund (JTF) had extended
its $2.1 million Public Awareness/Risk Communication grant
deadline from March 2007 to March 2008. Aitkin described
the working group for public awareness messages, which
includes the Ministry of Health, LBVD, international NGOs,
FAO, and WHO. The Minister of Health exercises final
approval and all partners will use communally developed
materials. On February 23, UNICEF delivered the first
posters and pamphlets funded by the JTF grant to the GOB
for distribution through LBVD and Health Department offices

RANGOON 00000203 004.2 OF 004


in all townships.


17. (U) Dr. MacArthur and emboff visited the Central
Epidemiology Unit (CEU) of the Ministry of Health to
observe CEU storage of Personal Protective Equipment (PPE)
units. Twenty-five units were stored in the CEU's meeting
room; however, since the CEU will soon relocate to Nay Pyi
Taw, the GOB plans to move the PPEs to another location in
Rangoon to remain close to epidemiologic investigation
teams based here.


18. (SBU) All IOs and INGOs praised the GOB's coordination,
cooperation, and openness with the international community
on AI. Government officials reported immediately the
questionable blood test results found during routine
surveillance and requested outside assistance without
delay. USAID and FAO visitors and post's APHIS employee
were given access to laboratories and officials promptly.
The response to sparrows that died in Chin State - alerting
authorities, isolating the birds and area, conducting post
mortem examinations and making final notifications -
followed all recommended procedures.


19. (SBU) Comment: Despite modest resources, the GOB has
implemented AI surveillance, awareness, and reporting
programs broadly and quickly. The regime has long
experience dictating orders from the center, tasking
relevant officials, as well as security officials, to
ensure compliance and reporting. However, its track record
is weak with regard to ensuring accurate information gets
transmitted back up the chain. It also does not usually
explain why its orders must be followed, so
internationally-supported education campaigns will be
needed to inform villagers why precautions must be taken to
minimize the threat of AI. In addition, regular visits by
UN agencies and international donors at local levels can
provide confirmation that accurate information is getting
reported back up the chain. End comment.


20. (U) Dr. John MacArthur cleared this cable.
VILLAROSA